PRE-OPERATIVE CARE

Chlorhexidine-Alcohol versus Povidone-Iodine

Chlorhexidine-Alcohol versus Povidone-Iodine

Introduction

Surgical site infections remain a complication which common is estimated today? Hue about 1% of interventions surgery in the United Kingdom. This risk depends on both the technicality of surgeon, type? intervention (classified in "clean surgery", " clean contaminated surgery "," surgical contaminated "and" dirty surgery and infected ") and the patient himself (general and possible colonization by Staphylococcus aureus). It is therefore conceivable that the? a major factor on which we can hope to act is the preventive? cutaneous antisepsis. But despite discussing the importance of the issue were not available until? Here for? Large randomized studies scale to compare different preparations antiseptics in this indication.

Assignment Question

In adult general surgery patinas is chlorhexidine-alcohol effective than povidone-Iodine for preoperative skin preparation at reducing surgical site infection?

Discussion

Its antimicrobial activity is related to the injury and destruction of cytoplasmic membranes causing leakage of cell contents. The action antimicrobial chlorhexidine is slower than alcohols, but it is significantly extended and is not modified by the presence of organic material (blood, serum, proteins). Chlorhexidine is active on Gram-positive bacteria, but less active against Gram negative. Chlorhexidine is active against some against the tubercle bacillus and is totally ineffective against spore-forming bacteria. The antiviral activity and variable and it must be emphasized that it is less marked against viruses not wrapped. By its toxicity, chlorhexidine should not come into contact with the cornea, the inner ear, brain or meninges. Chlorhexidine is available in aqueous or alcoholic solution. The combination allows for an alcohol prolong the effect but not powerful residual alcoholic compounds.

Observations of both of these articles revealed that hand antisepsis was an effective way to limit bacterial manuportage. Today, it is accepted by all caregivers that perfect hand hygiene is essential. There are however regularly the compliance caregivers for hygiene of hands (observed in real situation) rarely exceeds 50%. The reasons for these poor figures are numerous. The time required for correct hand hygiene seems to be a factor determinant of compliance [2-4]. Indeed, for washing hands with water and soap, stop its activity, go to the sink, wet hands, make a soaping and rinse hands, dry them before to leave the bedside. Although this sequence does not require more than 60 to 90 seconds, it is a major barrier to optimal adherence. Other parameters such as male gender, socio-professional category, (Compliance among physicians is typically lower than nurses), a caregiver-patient ratio unfavorable workload important (as observed in the ICU) are parameters limiting compliance with hygiene hands. More recently, three work has emphasized the importance of the Hawthorne effect in the assessment of compliance, that is to say, the importance of knowing observed [4-6]. The introduction of alcohol-based hand rub, its simplicity allows implementation objective of improving compliance of hand hygiene [2, 7]. The alcoholic solutions, by their good skin tolerance, are generally preferred to traditional hand washing with soap and water. The team Geneva noted that the introduction of the friction associated with alcoholic hand other preventive measures, ...